Oral Answers to Questions

Debate between Nadine Dorries and Tim Loughton

Tuesday 23rd June 2020 Commons Chamber

[Tim Loughton (East Worthing and Shoreham) (Con)]

What steps he took to promote Infant Mental Health Awareness Week.

[The Minister for Patient Safety, Mental Health and Suicide Prevention (Ms Nadine Dorries) [V]]

[Inaudible.]

Historical Stillbirth Burials and Cremations

Debate between Nadine Dorries and Tim Loughton

Thursday 6th February 2020 Commons Chamber

[Ms Dorries]

I certainly hope so. In fact, those parents and women who are coming forward now are enabling us to move along the pathway to women being given the full, correct information about what happens when a maternity incident takes place. We still have a long way to go, but, as I said at the beginning, the hon. Member for Swansea East is part of that process. The debates that we have here about baby loss are also part of that process. There is not one answer, one sledgehammer, that comes from the Department of Health and Social Care. Everybody has a role to play, because this is an issue that is spread over decades. It is about culture, and it is about the culture in hospitals today. It is about the esteem in which women and mothers are held within society. It is a complex picture with many parts, and everybody has an opportunity to play their part, as do those women who are now coming forward to ask where their babies’ ashes are.

Some hospitals arranged for stillborn babies to be cremated and told the parents that, because the baby was small, it would not be possible to recover any ashes. Even if ashes were recovered, their parents were not told. The ashes might have been spread in a dedicated garden of remembrance, but in other cases they might simply have been disposed of or kept in storage at the crematorium.

Over the past 20 years, we have heard about the discovery of mass graves containing the remains of stillborn babies in, among other places, Lancashire, Devon, Middlesbrough and Huddersfield. The 2015 review of infant cremations at Emstrey commercial crematorium in Shrewsbury found that, by using appropriate equipment and cremation techniques, it is normally possible to preserve ashes from infant cremations.

We now recognise that parents are committed and connected to their children long before birth—I think we knew that back then—perhaps at the point of conception or even earlier, when women imagine themselves being mothers for the first time. I am happy to say that, nowadays, parents of stillborn babies are able to be as involved in decisions about what happens to their baby as they choose to be. New regulations were introduced in 2016 to ensure that parents’ wishes for the cremation of their children are respected. The regulations introduced include a new statutory definition of what constitutes ashes or remains and require cremation request forms to be amended so that family’s wishes are explicitly recorded prior to any cremation.

Thanks to tireless campaigning by the hon. Member for Swansea East, the Government launched the children’s funeral fund last July so that bereaved parents do not have to worry about meeting the cost of burying or cremating their child or stillborn baby. The fund is available regardless of a family’s income and also includes a contribution towards the cost of the coffin. We have received over 1,000 claims to date, and I am sure that the hon. Lady must be incredibly proud.

The hon. Member for Swansea East called for this debate to consider what we in Parliament can do to help bereaved parents who did not have the opportunity to bury their stillborn babies and now wish to trace their final resting places. We know that parents never forget their babies, no matter how long ago their death occurred. Unfortunately, tracing a baby’s grave or a record of cremation may not be easy, and it can be a difficult time for people, both mentally and emotionally.

Records containing information about the locations of the remains of stillborn babies are not held centrally. Parents therefore need to start their search by contacting the hospital where the baby was stillborn, as I am sure the hon. Lady knows. If records are still available, the hospital should be able to tell parents whether the baby was buried or cremated and the name of the funeral director who made the arrangements at the time—if, indeed, a funeral director was involved. Hospitals do not keep records indefinitely, and some records may not contain enough detail to be helpful. The hospital where the baby was stillborn may have closed or the funeral director involved—if one was—may no longer be in business.

Cemeteries and crematoriums, though, are legally obliged to keep permanent records. If neither the hospital nor the funeral director has a record of which cemetery or crematorium was used, parents can contact local cemeteries and crematoriums, starting with those nearest to the hospital where their baby was stillborn. As I mentioned, in many cases stillborn babies were and may still be buried in a shared grave with other babies. These graves are usually unmarked, although they do have a plot number and can be located on a cemetery plan. In many cases, several babies were cremated together. The crematorium should have a record of where the ashes are scattered or buried, but I am afraid the emphasis is on the word “should”.

My sympathies lie with families who have had to deal with the pain of not knowing what happened to their children’s remains for so many years. It is hard for many of us to imagine how long that pain must last. The Department of Health and Social Care expects all hospitals to provide as much information as they have available to any parents who inquire about what happened to their stillborn babies, no matter how long ago they died.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I echo the Minister’s tribute to the hon. Member for Swansea East (Carolyn Harris).

It is unimaginable to think that parents who lost their child through stillbirth were not even privy to the arrangements for the cremation or burial of that child’s body—it was a completely different world.

On the Minister’s last point about urging hospitals to co-operate as much as possible, there is a bigger issue in that some of these children may not have been stillborn. Where a child lived for a while, as in the case she cited from 1976. there are greater questions to be asked about the child’s birth in that hospital. As a result of my Civil Partnerships, Marriages and Deaths (Registration etc) Act 2019, coroners will have the power, when the regulations are introduced, to look at such cases. Does she agree that there is a serious question not just on the whereabouts of a baby’s remains but on the circumstances of that baby’s birth?

[Ms Dorries]

That is an entirely different question but, yes, I completely agree with the substance of my hon. Friend’s point. I am sure he contributed to the Government’s consultation on the proposal for coroners to investigate stillbirths, which closed on 18 June 2019. The consultation attracted over 300 responses from a wide range of stakeholders. Officials in the Ministry of Justice and the Department of Health and Social Care have been working carefully to analyse the responses received. The question of babies who were not stillborn but who lived for a period of time before they died is possibly worth considering.

--- Later in debate ---

[Ms Dorries]

The hon. Lady is right; the NHS trust has the ability and the jurisdiction to conduct its own inquiry. I believe that NHS Improvement would have a similar responsibility. As a result of today’s debate, I am going to investigate a little more deeply within the Department how we can go about having an inquiry and what the terms of reference would be. It may be that such an inquiry is not possible, but I will certainly find out whether it is.

My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) asked for an update on the pregnancy loss review. I attended the APPG on baby loss a few weeks ago. We expect the report being done by Zoe Clark-Coates and Samantha Collinge to be published in spring/summer, and we expect to publish a Government response to the consultation in spring going into summer. Again, I will push and see how much longer that will take.

[Tim Loughton]

The problem is that nothing has been agreed, because the pregnancy loss review group has not met since 2018. If a report is imminent, it has not been approved by the panel members, including me and the hon. Member for Washington and Sunderland West (Mrs Hodgson). I do not know what will be presented to the Government before they can even respond. The Minister might want to investigate how the group came to conclusions of which we know little.

[Ms Dorries]

I will. If my hon. Friend drops me an email at my departmental address, we will look into that, and the officials will take it away. I am grateful to him for raising that, because I was not aware of it.

I do not think I have missed out anyone who made a speech. We have heard today how important it is to many parents to find the final resting place of their stillborn children’s remains. Unfortunately, that is not always easy or possible, and I have explained that such records are not currently held by the Government. Rather, they are held by local hospitals that arranged for burials or cremations with local funeral directors or crematoriums. In some cases, records no longer exist, or they may not contain enough detail to be helpful.

Nevertheless, I reiterate that the Department of Health and Social Care expects all hospitals to provide as much information as they have available to them to any parents who inquire about what happened to their stillborn babies, no matter how long ago they died. I would like to praise the 800 parents who have attempted to find out where their babies’ remains are, because they have helped to raise the profile of this issue. As the hon. Member for Swansea East said, only by raising the profile do we manage to get something done. We need to continue to do that, because that is how we will make progress.

We have also heard today about the new regulations and systems to ensure that parents are involved, as they want to be, in the burial or cremation arrangements for their stillborn children. Parents are required by law to register a stillbirth, and once registration has been completed the registrar provides parents with all the certification they need to organise their babies’ burial or cremation, and a funeral service if they so wish. The required burial and cremation forms ensure that the wishes of parents are recorded and respected. Many NHS hospitals still do make arrangements for funeral services and support parents to consider various options and to make the decisions that are right for them. Some parents may wish to arrange a private burial or cremation with a funeral director. Most funeral directors do not charge for their services for stillborn babies. Thanks to the hon. Lady’s efforts, the new children’s funeral fund supports parents, as I said in my opening speech.

A funeral can sometimes be a catalyst for people to begin processing a deeply profound loss. At such a time, parents mourning their stillborn baby need as much emotional support, compassion and understanding as possible. However, the quality of support can vary from one maternity service to another. This is why the Government have funded Sands, the stillbirth and neonatal death charity, to work with other baby loss charities and the royal colleges to produce a national bereavement care pathway. The pathway covers a range of circumstances of baby loss, including miscarriage, stillbirth, termination of a pregnancy for medical reasons, neonatal death and sudden infant death syndrome. The NBCP is now embedded in 43 sites, and a further 59 sites have formally expressed their interest in joining the programme.

I would like to talk a little bit about mental health support. The hon. Member for Kingston upon Hull North is a campaigner on this, and she raised mental health during her speech. A couple of weeks ago, I visited nurses who are delivering perinatal mental health care support. As part of the new approach to and new funding for mental health, there are now specialist perinatal mental health community services in all 44 local NHS areas in England, and further developments are planned. Just in 2018-19, this has enabled over 13,000 additional women to receive support from specialist perinatal mental health services, against a target of 9,000.

I spoke to the nurses about the perinatal services that are being delivered, and in that particular trust they have helped 700 women who previously had no assistance whatsoever. It was incredible to hear the stories of how that assistance—the mental health support—is now being given to women. As I have said, all trusts now have in place those perinatal support services, which were never there before. Again, that is a huge step on the path towards delivering services that are focused on women and their needs.

Via maternity outreach clinics, we are also providing targeted assessment and intervention for women identified with moderate or complex mental health needs arising from or related to their maternity experience who would benefit from specialist support, but where it may not be appropriate or helpful for them to accept specialist perinatal mental health services, so we are even thinking further than that. In those services we are also assisting partners and families, so it is not just for the women, but for their partners and families.

A huge amount of work is being done in this area. I am not saying that we have finished—there is more to be done—but we are making progress. This actually fits in very well with our women’s agenda in the Department of Health and Social Care. The women’s agenda is not just about periods and menopause; it is about so many things. The particular area we are discussing today is a huge part of that.

Hon. Members present for the Baby Loss Awareness Week debate last October may recall that I undertook to write to Professor Jacqueline Dunkley-Bent, the chief midwifery officer in England, to ask if those bereaved by baby death could be included in the NHS long-term plan commitment to develop maternity outreach clinics that will integrate maternity, reproductive health and psychological therapy support for women with mental health difficulties arising from or related to the maternity experience. I am delighted to tell the House that I recently received a letter from the chief midwifery officer confirming that access to these services is available to women and their partners who are experiencing moderate or complex/severe issues, so we have listened and we have addressed that need. At this point, I should pay tribute to Professor Jacqueline Dunkley-Bent for her understanding of and support for my role in helping to deliver better services to women.

As I have said, a funeral can often be a catalyst for helping people to deal with death and stillbirth death, and I believe that that is so important today. It used to be about protecting women or just not holding them in high enough esteem to inform them about what happened, but we now know that actually the opposite is true. As my hon. Friend the Member for East Worthing and Shoreham mentioned, it is important to be involved not just in the death, but in what happened before, during and just afterwards. The question parents have at a time like this is: why? That question needs to be answered, and it does not get answered in a sentence or in a minute. Parents need to know and women need to know. They can only feel as though they have fulfilled their own responsibility to their child when they have explored every avenue and know every detail of what happened.

Oral Answers to Questions

Debate between Nadine Dorries and Tim Loughton

Monday 3rd September 2012 Commons Chamber

[Nadine Dorries (Mid Bedfordshire) (Con)]

1. What progress his Department has made on steps to improve the protection of children in care from sexual exploitation.

[The Parliamentary Under-Secretary of State for Education (Tim Loughton)]

Let me welcome you, Mr Speaker, back from the recess—without a tan. In July I published a report describing extensive progress on implementing last November’s “Tackling Child Sexual Exploitation” action plan. Although all children are potentially at risk, particular challenges arise for children in care, especially those in children’s homes. Accordingly, I announced urgent action to improve children’s residential care, including developing a clearer understanding of when children go missing, allowing Ofsted to share the locations of children’s homes with the police and examining out-of-authority placements.

[Nadine Dorries]

I am sure that the Minister is aware that 45% of children who are in care and looked after are in homes away from their borough. They are removed from their networks of support and the familiarity of adults whom they can trust, which makes them more vulnerable and more prone to abuse. Does he agree with the report by the deputy Children’s Commissioner that children should be cared for as close to home as possible, and, if so, what steps are we taking to ensure that happens?

[Tim Loughton]

I entirely agree with my hon. Friend on that point. That is why I launched the progress report jointly with the deputy Children’s Commissioner, picking up what I believe to be the scandal of too many vulnerable children—almost half, as my hon. Friend said—being placed a long way from familiar environments. We have set up a task and finish group specifically to look at the problem and at how we can keep children closer to home and familiar environments when that is in their interests. The group will report back to me within the next few weeks and we will take specific action as a result.